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Pediatric heart allocation phase 2 system changes on July 7

Pediatric heart allocation phase 2 system changes on July 7

Important  note: This article was updated on May 31, 2016, to add additional information to the transition plan for pediatric candidates when this project is implemented on July 7. We are sorry for any confusion this omission may have caused.

 Primary audience: pediatric heart program staff

Background

OPTN/UNOS Board of Directors approved policy changes in June 2014.

We are currently working to complete the second phase of a two-part project to decrease waiting list mortality for pediatric heart transplant candidates. In March, we implemented phase 1, which revised pediatric heart status 1A and 1B justification forms in WaitlistSM to reflect the new status criteria.

We will make the following changes on July 7, 2016:

  • Increase the qualifying isohemagglutinin titer to 1:16 or less for Status 1A/1B candidates who are one year old or older, but registered before their second birthday, and who are willing to accept intended blood group incompatible heart offers.
  • Add a new the treatment question “Has candidate received any treatments within the prior 30 days that may have reduced titer value to 1:16 or less?”
  • Change the allocation priority of candidates under one year old, and candidates eligible to receive intended blood group incompatible heart offers.
  • Eliminate the option to register heart candidates as in utero.
  • Remove outdated policy language
  • Modify reports in Waitlist.

Important: Transition plan for pediatric candidates at implementation

Please see notes and actions you may need to take when we implement the changes on July 7. 

  • For candidates who are less than one year old on July 7
    • If they have titers entered, the titer values will not be affected.
    • The response to the treatment question (“Has candidate received any treatments within the prior 30 days that may have reduced titer value to 1:4 or less?”) will not transition over to the new system.
    • The next time titer data are updated, members will have to answer the new treatment question (“Has candidate received any treatments within the prior 30 days that may have reduced titer value to 1:16 or less?”)
  • For candidates who are one or older on July 7, but less than two years old at the time of registration, the following actions are required for candidates to be eligible for intended blood group incompatible offers as of July 7:
    New – added 5/31/2016 
    • The system will display the previously entered titer values but they will not be used.
      • Action required: Members must reenter the titer values if they have not yet expired, or enter the new titer values.  
    • The response to the treatment question (“Has candidate received any treatments within the prior 30 days that may have reduced titer value to 1:4 or less?”) will not transition over to the new system.
      • Action required: Members will have to answer the new treatment question (“Has candidate received any treatments within the prior 30 days that may have reduced titer value to 1:16 or less?”)

Resources

View a toolkit of materials that explain the changes, including policy and system instructional recordings, frequently asked questions, and more. Read the policy notice for more information.

Questions?

If you have additional questions relating to policy, contact your UNOS Regional Administrator at 804-782-4800.

If you have questions relating to the system, contact UNOS Customer Service (UNet Help Desk) at 800-978-4334.

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